口服补充谷氨酰胺对早产儿肠道通透性及坏死性小肠结肠炎/败血症发生率的影响。

The impact of oral glutamine supplementation on the intestinal permeability and incidence of necrotizing enterocolitis/septicemia in premature neonates.

作者信息

Sevastiadou Sofia, Malamitsi-Puchner Ariadne, Costalos Christos, Skouroliakou Maria, Briana Despina D, Antsaklis Aris, Roma-Giannikou Eleftheria

机构信息

Department of Neonatology, Alexandra Regional General Hospital, Athens, Greece.

出版信息

J Matern Fetal Neonatal Med. 2011 Oct;24(10):1294-300. doi: 10.3109/14767058.2011.564240. Epub 2011 Apr 4.

DOI:10.3109/14767058.2011.564240

PMID:21463215

Abstract

OBJECTIVE

To examine the impact of oral glutamine (Gln) supplementation on gut integrity and on the incidence of necrotizing enterocolitis (NEC)/septicemia of premature neonates.

METHODS

Preterm neonates (n = 101, gestational age <34 weeks, birth weight <2000 g) were randomly allocated to receive from day 3 to day 30 postpartum, either oral Gln (0.3 g/kg/day, n = 51-Gln group) or placebo (caloreen-isocaloric, n = 50-control group). Intestinal permeability was determined from the urinary lactulose/mannitol recovery (L/M ratio) following their oral administration and assessed at three time points: day 2 (before first administration), day 7 and day 30 of life. The incidence of NEC and septicemia over the study period was also recorded.

RESULTS

A decrease of lactulose recovery at days 7 (p = 0.001) and 30 (p < 0.001) and a decrease of L/M ratio at day 7 (p = 0.002) were observed only in the Gln group. Lactulose recovery and L/M ratio at day 7 (p = 0.022 and p = 0.004, respectively), as well as lactulose recovery (p = 0.001), mannitol recovery (p = 0.042), and L/M ratio (p = 0.001) at day 30, were decreased in the Gln group as compared to controls. NEC and septicemia were lower in the Gln group at the end of the first week (p = 0.009 and p = 0.041, respectively) and up to the end of the study (p < 0.001 and p = 0.048, respectively).

CONCLUSION

Oral Gln administration may have beneficial effects on intestinal integrity and the overall incidence of NEC/septicemia in preterm infants.

摘要

目的

研究口服谷氨酰胺（Gln）对早产儿肠道完整性以及坏死性小肠结肠炎（NEC）/败血症发病率的影响。

方法

将101例早产儿（胎龄<34周，出生体重<2000g）随机分为两组，产后第3天至第30天，一组口服Gln（0.3g/kg/天，n = 51 - Gln组），另一组口服安慰剂（卡洛林等热量，n = 50 - 对照组）。口服乳果糖/甘露醇后，通过尿中乳果糖/甘露醇回收率（L/M比值）测定肠道通透性，并在三个时间点进行评估：出生后第2天（首次给药前）、第7天和第30天。同时记录研究期间NEC和败血症的发病率。

结果

仅在Gln组观察到第7天（p = 0.001）和第30天（p < 0.001）乳果糖回收率降低，以及第7天L/M比值降低（p = 0.002）。与对照组相比，Gln组第7天的乳果糖回收率和L/M比值（分别为p = 0.022和p = 0.004），以及第30天的乳果糖回收率（p = 0.001）、甘露醇回收率（p = 0.042）和L/M比值（p = 0.001）均降低。在第一周结束时（分别为p = 0.009和p = 0.041）以及研究结束时（分别为p < 0.001和p = 0.048），Gln组的NEC和败血症发病率较低。